protect provide unite

An advertising campaign on the Public Health impacts of Climate Change in Palau

Agency 1244InstructorJerry Bush

Teacher’s AssistantJack Piatt

Agency PresidentSarah Hubbs

Agency Creative DirectorJulia Fromme

AgencySiania AllenShakari BurtonNicholas CampiseJeffrey ChandlerLauren EdelLauryn FisherkellerJeremy GarrettKristina KaganerCassie KeysAndrea LikesAriel RunyonBrittany SchorfheideRichard SerritellaKendra TorresEric Wallace

PhotographersGenna OrdJulia Rendleman

TV/Radio ProducerChu Batsaihan

Specialthanks to:Centers for Disease Control and PreventionDr. Mark Keim, M.D.Mollie Mahany, M.P.H.

Palau Ministryof HealthDr. Stevenson Kuartei, M.D.Pearl Marumoto, BPHDekei NgiramengiorJane OlsudongSharp SakumaGaafar J. UherbelauDeidre Yamanguchi

IntroductionSituation AnalysisClimate Change MatrixPrimary ResearchKey IdeaTarget Market ProfileObjectivesStrategyBudgetEvaluation SectionConclusionReferencesAppendix

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This campaign is designed to raise the awareness level of select target audiences about the public health risks associated with the impacts of global climate change. The campaign is scheduled to take place during a six-month period between April 1st, 2011 and October 1st, 2011.

Primary research was conducted between September 18th, 2010 and October 26th, 2010 measuring awareness levels of citizens of Palau. The first step of the primary research was to acquire awareness level data through a survey. A sample of one hundred and forty eight Palauan’s from a variety of ages and occupations responded to a ten-question survey. Based on the total population size of 20,000 and survey sample size of 148 respondents, a confidence interval (margin of error) of 8.03 can be expected.

The second step in obtaining primary research data was through a series of interviews conducted with Palauan public health officials, fishermen, farmers, etc, as well as numerous photographs and videos pertaining to climate change issues in Palau.

Secondary research was gathered through a variety of resources (see “references” page) and has been categorized into three climatic events (extreme heat, seal-level rise, el Niño effects). A matrix was designed to

show the correlation between these climatic events and the increased health risks associated with each.

The main focus of the campaign is on the population that is already “healthy.” The “key idea” for the campaign centers on an interview with Palau’s Minister of Health, Dr. Stevenson Kuartei. He uses an analogy based on flight instructions that airlines use during flight safety demonstrations. Passengers are instructed to make sure their own oxygen masks are securely in place before assisting other passengers or children. According to Dr. Kuartei, the most vulnerable population is the one that is already “healthy.” Dr. Kuartei’s theory stems from the fact that this population must remain healthy in order to provide assistance to those that are “less healthy” or “less capable” of helping themselves.

It is from this analogy that we derived our campaign theme:

“PROTECT, PROVIDE, UNITE.” “Protect (yourself), Provide (assistance to others), Unite (for a healthier Palau).” The advertising messages were creatively designed to demonstrate both the health risks associated with climate change as well as desired preventative measures. Messages will be delivered at a high rate of frequency through a variety of mediums and events, over the six-month campaign time frame.

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Sea-‐level RiseGlobal climate change has been a popular area of

study and the field of research has been growing in recent years. Scientific research has addressed many aspects of climate change, but very few studies have covered the health impacts related to the climate. The health impacts are becoming greater for Palau and other small island developing states in the South Pacific due to their high vulnerability to climate change (Palau Project Proposal, 2008). Of the climate change impacts that Palau is facing, sea level rise poses one of the greatest threats to the country’s social, economic, and environmental sustainability (Republic of Palau, 2002). Based on future projections for the 21st century, the incidence of increased sea level is 66-90% more likely to occur (Keim, 2010a). The Intergovernmental Panel on Climate Change (IPCC) also reported on this trend in 2001, stating “the sea level is estimated to rise 50-90 mm within the next 50-100 years” (Republic of Palau, 2002). With continued sea level rise, increasing damage from coastal flooding areas will occur in the Pacific region, resulting in crop damage and other health hazards creating threats for the public health of Palau.

Crop DamageWhile the agricultural industry only makes up 6.2% of

the islands Gross Domestic Product (GDP), cultivation of

crops in Palau is critical to “socio-economic development and cultural as well as religious obligations” (Palau Project Proposal, 2008). A survey done in 2007, by Dr. Mark Keim, reported on the damage in two Pacific island countries, Lukonoch and Oneop. These islands faced severe crop damage that resulted from salt-water intrusion, an effect of sea level rise (Keim, 2010b). The two countries from the study lost a significant amount of taro; the main dietary source of carbohydrate (Keim, 2010b). Twelve of 40 homes on one island reported partial loss and damage, while another six of 40 homes reported a complete loss of the crop (Keim, 2010b). Palau has also felt the effects of salt-water intrusion on taro crop. The taro that was destroyed during the El Niño event of 1998 resulted in a 0.7% loss of their GDP (Republic of Palau, 2002). Saltwater intrusion, stemming from sea level rise and the El Niño event resulted in a loss of 75-100% of taro crops in the states of Angaur and Peleliu (Permanent Mission, 2009).

Sugar cane and tapioca are other crops commonly cultivated on many islands in the South Pacific. Excess water and salt-water intrusion caused by sea level rise, deter the growth of the crops (Gawander, 2007). The roots of sugar cane extend one meter into the

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Situation Analysis cont’dground, making lower water tables desirable for growth (Gawander, 2007). The water table where sugar cane is planted is typically three to 13 meters below ground level. With a rise in sea level, there is potential for the water tables to rise and hinder the quantity and quality of the sugar produced (Gawander, 2007).

Taro, tapioca, and sugar cane are main staple foods in Palau, however they are not the only crops being damaged by sea level rise and salt-water intrusion. Most medicinal plants “grow relatively fast, have high reproduction rates, and are typically resistant to salt water, making them more resilient to some of the predicted effects of global climate change” (Cavaliere, 2009). Although medicinal plants appear to be resilient, their biggest threat from sea level rise is the complete loss of the island they inhabit, which has the potential to occur given the rate of the increasing sea level (Cavaliere, 2009).

For Palauans, the loss of medicinal plants impacts the public health and also cultural significance. In an interview with Dr. Stevenson Kuartei, Minister of Health for Palau, the importance of traditional medicine in the Palauan culture was discussed. In regard to Western medicine, Dr. Kuartei said, “we as Palauans need to think of our traditional healing as the healing for us and actually Western medicine coming in, is the alternative healing” (Minister of Health, 2010a).

Dr. Kuartei goes on to say, “When we begin to build a narrow definition of health or medicine, we lose some of the flavor of what we traditionally think of as health or healing” (Minister of Health, 2010b). Through this interview, we are shown the importance of medicinal plants to the health and culture of Palauans.

With climate change causing a decrease in the availability of traditional crops available for consumption, there has been a shift towards a diet containing more processed foods. As a result, dietary education is gaining importance. Two of the health areas for the most concern and education in Palau are diabetes and obesity. Due to sea level rise, the growing conditions for crops are unfavorable and “penetration of local markets by cheap, poor quality imported foods with little nutritional value has brought health problems with increased rates of non-communicable diseases, such as obesity, diabetes and heart disease” (Barnett, 2007).

The main non-communicable disease threatening Palau as a result of a shifting diet is obesity. Currently “Palau ranks seventh in the world when it comes to obesity, according to the World Health Organization” (Island Business International, 2010). A Palau


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Community Health Assessment Survey indicated that 58% of Palauan males and 62% of Palauan females are obese (Republic of Palau, 2010b). School children account for 18.5% of the obese population in Palau and an additional 15% of children are at risk for obesity (Island Business International, 2010). To lower these numbers, the Ministry of Health is working alongside the Ministry of Education to develop a Healthy Lifestyle curriculum for school age children (Island Business International, 2010). Dr. Stevenson Kuartei proposed more balanced meals for schools, dietary education, and also suggested a reduction in the amount of rice and flour that is consumed. He suggested the “need to go more local with fish and taro” (Island Business International, 2010). With crop damage to local food as a result of the sea level rise and the availability of locally grown foods decreasing, proper education on a new diet is needed. Without education, obesity will continue to increase.

Obesity and being overweight increase the risk for chronic diseases, such as diabetes. Diabetes is on the rise in the South Pacific with a staggering 40% of the 9.7 million people in the region being diagnosed (World Health Organization, 2010). This number is extremely high compared with the 13% of the United States

population who has been diagnosed with diabetes. According to the disease registry in Palau, in 2004, there were 776 people admitted into the diabetes registry (Republic of Palau, 2005). Diabetes was also listed in the ten leading causes of death for Palauans. The average age that people in this region are developing diabetes is becoming lower every year. Only 16% of the population in Fiji is above the age of 55, due to premature deaths that are related to diabetes. In this region, diabetes accounts for 75% of all deaths and 40-60% of healthcare costs (World Health Organization, 2010). The rise in diabetes is related to crop damage and the access to traditional food that provides proper nutrients. Dr. Temo K. Waqanivalu of the World Health Organization also notes that, “promotion of traditional foods has fallen by the wayside. They are unable to compete with the glamour and flashiness of imported foods” (World Health Organization, 2010). Again, dietary education is important to combat this. As suggested by Ateca Kama, a nutritionist at Fiji’s National Food and Nutrition Centre, a consistent program that translates the importance of knowledge into behavior would be beneficial in helping lower these risks (World Health Organization, 2010).

Vector Borne InfectionsDestructive and invasive water borne and vector

borne diseases, including dengue fever, malaria, and encephalitis, are increasingly affecting those areas in the ecosystem that are most susceptible to flooding, such as low-lying homes and regions in standing water. For developing island nations such as Palau, a majority of water-borne infectious diseases results in cluster outbreaks. Vector-borne diseases, such as malaria and dengue fever, are projected to increase as warmer temperatures facilitate vector range expansion and speed up virus replication. The potential increase in the spread of such vector-borne diseases depends primarily on the climactic factors and the effectiveness of Palau’s public health system (World Health Organization, 2003).

In 2008, low-latitude regions of Palau had reached epidemic levels of Dengue fever, confirming 31 cases of people having been exposed. Palau’s Minister of Health Dr. Stevenson Kuartei said, “Palau is at risk of a major dengue fever epidemic that will have long lasting health and economic consequences” (Carreon, 2008). The dengue fever virus is transmitted from one person to another by the Aedes mosquito. These mosquitoes are prone to bite during the dawn and dusk hours of the day, and are most susceptible to biting in areas

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Situation Analysis cont’dof standing or stagnant water. Those bit by the Aedes mosquito start showing symptoms within five to 15 days of the initial bite. Symptoms of dengue fever can last up to two weeks and involve flu-like symptoms, such as headaches, rashes, cramps and back and muscle pain (Republic of Palau, 2010a). However, if compliant health measures and treatment is delayed or not met, this disease can be fatal to those susceptible. Kuartei said that because of budget reductions, there remains sufficient difficulty in retrieving adequate resources for community mobilization, vector control, surveillance and critical management for those who have been and are susceptible to infection (Carreon, 2008). In 2008, Kuartei also raised the concern that the Belau National Hospital is running at almost the full capacity because of the regular admissions and the dengue fever cases (Carreon, 2008). Though there has been no new information regarding the amount of dengue fever cases seen by the hospital, the Center for Disease Control and Prevention (CDC) issued an Outbreak Notice in June 2010 regarding the infection. The notice reported that individuals should continue to take preventive measures because dengue fever is still circulating throughout the region (CDC, 2010b).

In areas with high transmission, the most vulnerable groups are young children and pregnant women. According to the CDC, malaria is the fifth leading cause of death for infectious diseases in low-income regions. Increased rainfall and standing water due to flooding allow the transmission of this vector borne disease to be highly transmissible all year round (CDC, 2010a). Costs to

individuals and their families include: purchase of drugs for treating malaria at home; expenses for travel and treatment at dispensaries and clinics; lost days of work; absence from school expenses for preventive measures; expenses for burial in case of deaths (CDC, 2010a).

Finally, with respect to infectious disease disasters we can provide personal protective equipment and adequate sanitation and hygiene so as to prevent the exposure of healthy populations to biological hazards, like infectious disease. In the case of epidemics, we fight human disease by reducing exposures to the cause, which is a bacteria or virus (Keim, 2010b).

Dr. Keim reported that we reduce people’s susceptibility to epidemics by “providing them with adequate nutrition and preventive health care. We then increase people’s resilience or ability to bounce back after catching the disease, through access to curative health care and health promotion,” (Keim, 2010b).

Unpredictable TidesLow-lying coastal areas will be at increased risk

from coastal inundation due to sea level rise and storm surge, with major implications for coastal communities, infrastructure, natural habitats, and resources (Ministerial, 2000). Flooding will become more frequent due to higher storm tides, and coastal land will be permanently lost as the sea inundates low-lying areas and the shorelines erode (United States, 2009). Populations that remain isolated from



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the primary population are increasingly vulnerable to acquiring necessary health care and provisions in the event of climactic flooding as a result of unpredictable tides. Kayangel and Peleliu are states of Palau that remain highly susceptible for emergency medical aid or access to health care in the event of flooding (World Health Organization, 2003). These isolated regions are at a disadvantage “specific to the quality and accessibility of healthcare, medical workforce training and availability” (PEHI, Executive Brief, 2010).

Sea level rise is attributable to higher tides and storm surges, which will reduce or cut off health access in all populations, not just isolated ones (Joyce, 2007). Tides reaching surmounting heights increase the likelihood of roads and main emergency evacuation routes to flood, and medical services to be inaccessible. Dr. Stevenson Kuartei was asked about the issue of the Belau National Hospital being so close to the ocean. He recognized that the hospital is in a very vulnerable spot due to it being connected to the general population by only one causeway. If the causeway were to be washed out by a tidal surge, healthcare would be inaccessible to a main segment of the population (Minister of Health, 2010c). The hospital itself is very close to the water as well and a tidal surge could also overtake the hospital, again making healthcare inaccessible and unavailable. Dr. Kuartei also noted that the hospital has served as

a magnet for other health entities. While this may be positive for current access to health care, in the event of extreme weather, health services are not spread out enough to serve the community and could all be damaged by their location to the ocean (Minister of Health, 2010c).

Loss of land will affect living things in coastal ecosystems. Storm surges have major impacts on Pacific coastal island communities, including loss of life and damage to infrastructure and property (Joyce, 2007). Critical infrastructure, including homes and roads tend to be located along the coast. Flooding related to sea level rise negatively impacts port facilities and harbors, and causes closure of roads and bridges. “Long-term infrastructure would affect social services such as disaster risk management, health care, education, management of resources, and economic activity in sectors such as tourism and agriculture” (United States, 2009). Sea level rise, increased storm surges, flooding, beach erosion, and increased invasion of vector-borne diseases are among the threats that endanger the ecosystems that provide safety, sustenance, economic viability, and cultural and traditional values to these island communities.


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Situation Analysis cont’d

ResilienciesAlthough Palau and many islands in the South Pacific

are susceptible to the health risks of climate change, the opportunities for education and the robustness of their economy make them resilient.

The most significant piece of reducing vulnerability however, is overall human resilience. Dr. Keim’s “Six R’s” of resilience all incorporate some form of human behavior. The “Six R’s” include readiness, robustness, redundancy, resourcefulness, rapid response, and recovery, all risk reducers that are affected by human behavior (Keim, 2010a). These resiliencies are comprised of adaptive capability, response capacity, and recovery capacity. Educating the community on ways to be resilient can ultimately reduce individuals’ susceptibility to the health impacts of climate change. Dietary education can also increase resilience and improve the health of Palauans (Palau Community College, 2010). Opportunities for dietary education exist with children between the age of eight and sixteen. Dietary education can stress the importance of good dietary practices. According to Dr. Stevenson Kuartei, $10,000 has recently been obtained for use in the development of programs to combat childhood obesity (Island Business International, 2010).

The economic situation that Palau is in is partly in result of the Compact of Free Association between the United States and Palau. The Compact of Free Association was established in 1995 and the United States continues to assist Palau through direct assistance to their national government, investment in trust funds, federal postal, weather, and aviation services as well as construction of a major road (Government Accountability Office, 2008). The compact provides up to 15 years of economic assistance to Palau from the United States. In the recent 2009 fiscal year,

the terms of the contract were reviewed and the two governments made necessary modifications. According to the U.S Government Accountability Office, the United States aid to Palau exceeded $852 million from 1995-2009. “Compact direct assistance will account for 48 percent of U.S. assistance; this assistance provides general budgetary support for Palau’s government operations, including initial investment in a trust fund intended to provide annual distributions of $5 million in 1999-2009 and $15 million in 2010-2044” (Government Accountability Office, 2008).

Although Palau is a small island, its land provides the country with a vast amount of plausible opportunities for growth. Tourism continues to be Palau’s leading source of income accounting for the majority of the nation’s income. Tourism is one of the few resources that allow Palau to consistently bring in large profit independently, without the help of other nations. The nation’s unique and scenic marine life makes it one of the more popular destinations in the world. Hotel resort investments as well as cruise line partnerships continue to keep Palau’s economy aloft (Republic of Palau, 2007).

Extreme HeatCrop Damage

For the small island states of the Pacific, one of the concerns is drought. The extreme heat can lead to excessive dry land. Drought can then lead to thirst due to little water supply, wildfires due to the low moisture and little rainfall, and also crop damage or not being able to grow crops at all due to the land being too dry (West, 2010). Along with drought, there are also seasonal changes that come in to play because of global climate change. Since climate change has become an issue, the seasons for harvesting crops have changed and the numbers of crops harvested each season have declined tremendously (Minister Stevenson J. Kuartei, personal communication, September 14, 2010). The heat damage to the crops has been an issue also. The taro has not been as healthy as it has been in the past. Because of the low rates of crops being harvested, it has affected the attitudes of the people since they have no control over how much of the crops survive and this problem can also effect the safety of the food (Minister Stevenson J. Kuartei, personal communication, September 24, 2010).

Since there is crop damage and not as much harvested, Palauans depend on imported goods (Minister Stevenson J. Kuartei, personal communication, September 14, 2010). Although the Palauans have been



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getting accustomed to imported canned foods, they do not realize the health concerns that go along with that diet. As mentioned before, obesity is a major concern in Palau. Extreme heat also affects the medicinal plants that are very important to the culture of Palau. Many medicinal plants cannot hold up in certain environments. Temperatures can affect chemical compounds in these plants that are the source of the medicinal activity (Cavaliere, 2009).

Respiratory DiseasesRisks of respiratory diseases such as chronic

obstructive pulmonary disease, asthma, and bronchitis are on the rise due to extreme heat in Palau.

According to Deschenes & Moretti (2007), the main mechanism underlying the increased mortality in periods of excessive temperature is the additional stress imposed on the cardiovascular and respiratory systems by the demands of body temperature regulation. (p.7)

The additional stress on the body causes an internal vulnerability for other diseases.

There are many different causes for respiratory diseases that have to do directly with extreme heat. Increased temperatures may trigger forest fires, which lead to a higher amount of soot in the air and then consequently higher levels of respiratory disease (Haines & Patz, 2004). The temperature increase in the South Pacific is also causing an earlier start to birch

pollen season leading to more allergies and respiratory problems amongst people (Rasmussen, 2002).

The elderly population has the highest rate of mortality from respiratory diseases, largely because of pre-existing conditions that tend to be present (“Elderly Have Higher”, 2006). Chronic Obstructive Pulmonary Disease, also called COPD, is an illness that affects many people who live in extremely hot environments (Leader 2009). When it is hot outside, the body uses more energy to maintain a normal body temperature. Because of the excess energy that is used to try to keep the body cool, the body demands more oxygen (Leader 2009). People with COPD suffer shortness of breath while being in hot temperatures because the body is using extra energy to try to keep it cool, instead of using all of the energy to maintain steady breathing. Since people with COPD have trouble breathing in hot environments, this can lead to a Bronchospasm; a breathing problem where the airways reduce in size making it difficult to get air into and out of the lungs. To avoid this problem, the people of Palau need to pay attention to the weather reports, take medications as the doctor prescribes them, and keep cool by staying indoors (Leader 2009).


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Situation Analysis cont’dThe government is also taking measures to limit

the repercussions of extreme heat by making sure all government sector housing is set up with energy efficient matters that will make the needs for air conditioning obsolete. As earlier mentioned, a large amount of the Palauan population has a relatively low-income, the government has taken the initiative to make air conditioning units a thing of the past in order to reduce cost and improve quality of life (“Draft National Energy Policy”, 2009, p.9). According to the Draft National Policy (2009), “all new and refurbished government buildings will incorporate energy-efficient designs such as shading and orientation of buildings to reduce heating of buildings and reflective roof paint and attic heat radiation barriers to reduce the need for air conditioning” (p.9). The government is doing all they can to reduce the amount of these respiratory illnesses by taking these certain precautions and making it easier for people to breath in the extreme heat.

Heat-‐Related IllnessesSyncope occurs when a person loses consciousness

temporarily and faints. It is usually due to lack of blood flow to the brain (“Syncope”, n.d.). Being exposed to extremely high temperatures and overheating is one of the main causes to syncope. The pulse is usually

weakened, the heart is beating at a rapid pace, but body temperature is normal (“Syncope”, n.d.). Some of the symptoms of Syncope include blurred vision, sweating, nausea, lightheadedness, and yawning excessively (University of Maryland Medical Center 2010). People who are most at risk are older adults over the age of 65, as well as people who already have a history of heart disease, diabetes, or high blood pressure. Pregnant women are also at higher risk. To avoid Syncope, drink plenty of fluids, eat meals regularly, avoid standing for long periods of time, stay away from caffeinated drinks and alcohol, and sleep with the head of the bed raised (University of Maryland Medical Center 2010).

Dehydration is also an issue related to the extreme heat. This occurs when the amount of water exiting the body is greater than the amount of water being taken in. Several things can cause dehydration. These include diarrhea, vomiting, sweating, diabetes, burns, and the inability to drink fluids or the lack of fluids. Diarrhea is the most common way a person becomes dehydrated because a considerable amount of water is lost with each bowel movement. Sweating is also a



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major cause of dehydration, especially in the case of the Palauans; the environment is extremely hot and it is very difficult for them to retain water when they are constantly exposed to the heat (“MD- Travel”, 2010).

Heat Strokes are a more severe case of heat cramps and heat exhaustion that can be caused by dehydration in some cases. A heat stroke is a form of hyperthermia. The body temperature keeps rising to dangerous levels and the victim loses consciousness. A heat stroke is considered a medical emergency and can take the life of someone if it is severe enough. The individuals who are most vulnerable to having heat strokes are infants, elderly, athletes, and people who work outside in hot environments (“MD- Travel Health”, 2010). To prevent heat strokes, like many of the other preventative measures, the Palauans need to drink ample amounts of fluids, wear cool clothing, plan out the day so the work is done in the cooler parts of the day, keep indoor areas cool, avoid physical activity on extremely hot days, and stay tuned to the weather reports (Leader 2010).

Heat cramps are basically contractions in the muscles that are very painful. These mainly take place in the calf muscles. They tend to be caused by dehydration, exposure to excessive amounts of heat, and poor physical conditioning, and are prevented by drinking a lot of water and staying in

cool environments (“MD- Travel Health”, 2010).The South Pacific region is one of the most

vulnerable and prone to disaster in the world. Although the risks are incredibly high for heat related illnesses to occur, the medical sectors are not prepared well enough to respond to these types of emergencies (Keim, 2002). Differing from the other concerns of global climate change is the facts that heat related illnesses affect all populations. The other vulnerability previously mentioned with the other extreme heat issues is the health care access problem. It is hard to get treatment in Palau due to the limited access that the people have to the hospitals as well as the little access the medical providers have to the people (Keim, 2002).

Dr. Mark Keim outlined recommendations for emergency health management in the Pacific islands. The ones that relate to heat related illnesses include: Promoting education and training for any type of disaster. It is important to prevent these specific illnesses by developing prevention strategies, and improving emergency operations plans among the public health of Palau and the medical sectors (Keim, 2002).


El Niño EffectsEl Niño is a weather event that begins in the Pacific

and occurs when trade winds are weakened (Joyce, 2010). It has worldwide effects despite its humble origin. When this happens, weather conditions in the Pacific region are altered. In a strong El Niño, ocean temperatures in the Pacific can increase as much as two degrees above normal (Joyce, 2010), which can contribute unpredictable extreme weather (Joyce, 2010) and lead to coral damage (Freeman, 2003). In the eastern region near South America, warm water accumulates and causes an unusually high amount of rainfall that can cause flooding. On the western side of the Pacific, the opposite effect is experienced. Since the trade winds are not carrying moisture west from South America, areas near Indonesia experience drought that sometimes results in wild fires (Joyce, 2010).

Coral DamageA barrier reef encompasses the majority of the

main cluster of islands that stretches from the northern tip of Babeldaob to the southern lagoon, and merges with Pelelui in the south (Golbuu, Bauman, Kuartei, and Victor, 2005, p. 3).

Palau has the most diverse coral fauna of

Micronesia and the highest density of tropical marine habitats of comparable geographic areas around the world. In addition to coral reefs, mangroves, and seagrass beds, Palau has deep algal beds, mud basins, current swept lagoon bottoms, rich tidal channels, and anoxic basins within the rock islands. Many of these environments contain corals. (Golbuu et al., 2005, p. 3)

Palau boasts an impressive coral diversity, with findings of at least 385 coral specimens, in 66 genera (Golbuu et al., 2005, p. 3). Fish and other invertebrate are also extremely diverse, as there are 1,278 known species of reef fish in Palau. This is the highest diversity within Micronesia (Golbuu et al., 2005, p. 3).

Coral BleachingCoral reef bleaching is “the whitening of

diverse invertebrate taxa, (that) results from the loss of symbiotic zooxantheallae and/or a reduction in photosynthetic pigment concentrations in zooxanthellae residing within scleractinian corals” (Buchheim, 1998, p. 1). Coral bleaching outbreaks in Palau are considered to be one of the greatest threats to Palau’s coral reef ecosystems (Golbuu et al., 2005, p. 3). Sea temperature, solar irradiance, sedimentation,

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xenobiotics, subaerial exposure, inorganic nutrients, freshwater dilution, and epizootics are all natural and anthropogenic causes of coral bleaching (Buchheim, 1998, p. 1). Coral reef ecosystems are especially susceptible to the effects of climate change. “Exposure to maximum ocean temperatures just a few degrees above the long-term average at any location, can cause corals to become stressed, bleach, and die” (Munday, Jones, Pratchett, and Williams, 2008, p. 2). Scientific evidence shows that an increase in water temperatures when El Niño occurs is the primary stressor that causes coral bleaching. Even the slightest increase in water temperatures has the potential to bleach and kill many species of coral. While a temperature rise in itself can be enough to cause corals significant damage, “the stress is compounded by the presence of any other stress factors, such as windless days allowing more UV-light to reach corals, or low tides causing increased saltiness in lagoons” (McCormack, 2000, p. 1).

Palau’s reefs were significantly harmed by coral bleaching during the 1997-1998 occurrence of El Niño, and the reefs have not fully recovered from the damage caused. It is estimated that approximately one-third of Palau’s corals died during this event (Golbuu et al., 2005, p. 3). It is possible that global climate change may play a role in the increase of coral bleaching events, which could lead to destruction and extinction of numerous coral species (Buchheim, 1998, p. 1).

EcotourismCoral reefs are useful to people and their

environment in numerous ways. They protect shores from the impact of waves and storms, supply food and medicine, and are economically beneficial to local communities as their beauty attracts thousands of tourists each year.

Increasingly frequent El Niño occurrences have lead to more cases of coral bleaching, which can ultimately lead to decreases in tourism. Between the years of 1992 to 1997, tourist arrivals nearly doubled from 30,000 to 60,000 in Palau. However, Palau experienced a 3.3% decrease in their GDP in 1998. This significant decline may be attributed to the 1997-1998 coral bleaching event, as Palau’s coral reefs were severely damaged from this occurrence (Golbuu, 2005). According to the U.S. Global Change Research Program (2009) “the loss of income by 2015 from degraded reefs is conservatively estimated at several hundred million dollars annually.” Revenue lost through tourism causes many of Palau’s citizens to be affected financially. According to the Republic of Palau (2007), 54.4% of households have an income below $15,000, and loss in family income can lead to poor spending on food.


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Although tourism plays a critical role in Palau’s economy, tourists are also partially responsible for damage incurred to the reefs. Tourists who are uneducated about reefs can damage the coral significantly. “Snorkelers and divers who are not trained in proper behavior around reefs can trample delicate soft corals, damage reef structures and injure fish by attempting to feed them” (Freeman, 2003).

However, coral reef damage can be prevented in many ways. One way that Palau is monitoring its coral reefs is through the Palau International Coral Reef Center (PICRC). In 2001, the PICRC launched a nationwide coral reef monitoring program.

The objectives of the program are to: establish permanent monitoring sites, determine status of Palau’s reefs, assess changes to the benthic and fish communities at each site over time and examine the recovery process from the 1997-1998 bleaching event at each site (Golbuu et. al., 2005).

Fishing in PalauFishing is more than a popular sport in Palau.

Rather, fishing is just as relevant to Palau’s culture as it is to their diet, and it is an integral component of how Palauans live their daily lives.

In 2001, 835 people (16% of Palau’s population) sold their catch to local fish markets at least once during the year. A 2003 survey of subsistence

fisheries indicated that 87% of households have someone that fishes either for subsistence or commercial purposes, and often both. Only 13% of Palauan households were not involved in any type of fishing. (Golbuu et al., 2005, p. 7)

Palau’s marine resources have a long-standing history of being rich and diverse, and Palau is known for having some of the best sport fishing areas in the world.

Subsistence fishing within the reef is a major activity and dominates market production. Deep-sea fishing for pelagic species resulted in a tuna catch of 51 tons in 2000. Seasonal trochus harvesting for shell button manufacture is an important source of income for most fishermen. Other marine resources include pearls, shrimp, ornamental fish, seaweed (agar agar), and mollusks. (Encyclopedia of the Nations, 2010, p. 1)

Fish DistributionPhysical and biological changes that occur in our

oceans during El Niño events can vastly affect fish distribution. The National Oceanic and Atmospheric Administration (NOAA) states:

Among the variations in oceanographic features that are observed following an El Niño event are:



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changes in sea-surface temperatures, changes in the vertical, thermal structure of the ocean (particularly in coastal regions), and altered coastal and upwelling currents. These changes can directly affect the species composition and abundance of fish. (National Oceanic and Atmospheric Administration, 2010)

During the years that El Niño is not occurring, deep, cold ocean water rises, and with it comes nutrients that reside near the bottom of the ocean floor. Fish in the upper waters feed on plankton that depend on the nutrients transported in with the cooler water temperatures. In addition, kelp forests also rely on these cooler, nutrient-rich water supplies to survive and grow. El Niño reduces the upwelling of cooler water that supply the nutrients so crucial to life in more shallow waters. Because of this, fish either die or attempt to migrate to areas with more food available (Department of Fish and Game, 2010). The decrease in number of fish populations has not gone unnoticed by Palauans. Changes in fish distribution directly affect those who depend upon fish as a primary food source, as well as those that rely on fish as a source of income. Field surveys and fish aggregation studies show a decline in fish populations in Palau over the last decade (Golbuu et al., 2005, p. 7).

Weakened Trade WindsTrade winds were originally seen as a tool for

commerce, but scientists later discovered that they are vital to the climate and biological balance of the Pacific as they provide much of the rainfall. As the air moves west, it picks up moisture and rises. By the time the air reaches the end of the cycle, it is saturated and releases the moisture in the form of rain. After this, the air travels back toward South America and the cycle starts again (Than, 2006). In addition to providing rainfall in the Western Pacific, trade winds act as a driving force in ocean currents. These currents are key to the survival of ecosystems that exist in the shallow waters. As the currents drive west, they bring colder, nutrient-rich water toward the surface and provide nourishment for marine life in the shallow areas of the Pacific (Sample, 2006).

Research has shown that the trade winds have been slowing down since the industrial revolution. Since the mid 1800s, the strength of the trade winds have weakened by 3.5%. In addition, the ocean currents they propel have weakened by 7.5% (Sample, 2006). Scientists predict that the winds will weaken by another ten percent by the year 2100 (Hopkin, 2006).


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Situation Analysis cont’dScientists theorize that the slowing of trade winds

has a direct connection to global climate change. Due to rising temperatures, more water is evaporating and being absorbed by the atmosphere. However, the rate of rainfall is not increasing. In order for the cycle to sustain itself, the winds have to slow down to give the increase in moisture enough time to be released by the atmosphere (Than, 2006).

This vital cycle is being damaged by El Niño and threatens to change the marine ecosystems in the Pacific. If the currents are weakened, less nutrient rich cold water will be able to rise to the surface (Than, 2006). Microscopic organisms such as plankton and kelp rely on these nutrients to live. If the plankton population suffers, larger populations of marine life will also suffer. Fish rely on these smaller organisms for food. If the fish cannot find enough food, they will either die or be forced to migrate to different areas. Regardless of whether the fish die or migrate, the number of fish in areas that are warmed by El Niño will decrease (Department of Fish and Game, p. 1). The decrease of the food supplies for fish combined with the increase in water temperature are causing a great change in the ecosystem in which fish reside. This decrease in fish population threatens to damage the fishing industry in areas that are being affected by El Niño conditions, weakening trade winds, and currents (Than, 2006).

Extreme Weather EventsAccording to Dr. Mark Keim, Center for Disease

Control and Prevention, there will be an increase in the probability of extreme weather events due to more frequent El Niño oscillation caused by global climate change. The likelihood of future trends of heat waves and heavy precipitation events is said to be 90% - 99%; widespread drought, the incidence and severity of cyclones, as well as increased incidence of extremely high sea level is said to range from 66% - 99% (Keim, 2008, p. 508). These extreme weather events can cause a multitude of natural disasters and “ninety-five percent of natural disaster deaths occur among sixty-six percent of the poorest countries” (Anderson, 1991).

There are many impacts on public health, from both high and low precipitation events caused by the recurrence of El Niño. Loss of clean water, shelter, personal and household goods, sanitation, routine hygiene, disruption of solid waste management, public risk perception, increased pests and vectors, loss or damage to health care system, worsening of existing chronic illnesses, and toxic exposures are all effects of increased number of storms, floods, drought, and wildfire (Keim, 2008, p. 510).



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The trend of more areas affected by drought is said to be 66% - 90% more likely to happen within the twenty-first century. Agricultural, economic, and health problems are most often associated with drought-related deaths (Keim, 2008, p. 511). To cope with public health emergencies caused by drought, there needs to be both preparation before and action after such an event. The principal interventions need to focus on: food security, safe water and adequate sanitation, hygiene, infection in healthcare settings, surveillance, and temporary shelter for displaced populations (Keim, 2008, p. 512).

“Meteorological forecasting and early warnings have decreased morality of flash floods by greater than fifty percent” (Keim, 2008, 513). However, there are still many public health impacts of flooding which include: damage to homes and displacement of occupants, compromised personal hygiene, contamination of water sources, disruption of sewage service and solid-waste collection, injuries sustained during cleanup, stress-related mental health and substance abuse problems, as well as deaths caused by drowning. Drills and exercises should include population protection as well as an alert and notification system for such an event. “An early return of victims to routine activities of daily

living are known to lessen the health impacts of flood disasters” (Keim, 2008, p. 513).

Tropical cyclones, like drought, are also predicted to be more likely to strike within the twenty-first century. “In the past two centuries, tropical cyclones have caused an estimated 1.9 million deaths worldwide.” (Keim, 2008, p. 513). In order to prepare for tropical cyclones, weather monitoring and forecasting is essential. This can allow for timely implementation of safe evacuations to prevent drowning (the leading cause of cyclone death). Public education in schools, home, and at the work place can raise awareness of evacuation routes and plans (Keim, 2008, p. 514).

Many populations of Palau have vulnerabilities caused by cases of extreme weather. Dr. Kuartei, Palauan Minister of Health, explains that the vulnerable populations do not have the mechanisms to rise above their vulnerabilities. However, he believes the women, children and elderly only become highly susceptible to the dangers of extreme weather when the healthy are not looking after them. This is why he believes those who are healthy are the most vulnerable. Unless Palau


adopts a model that educates and protects those that are healthy and reside in the main cluster of islands, then the vulnerable will also suffer. (Kuartei, J, personal communication, September 24, 2010).

A portion of Palau’s population lives on islands that are outer lying, posing yet another risk as there is a rise in the occurrence of extreme weather events. Dr. Kuartei, explains how the people of Palau have always believed they have the power to turn the tide away if it ever becomes a problem. He discusses how Palauans believe time is not linear, but circular and if some of the outer lying islands were to be lost, then something new would one day come along to replace them. Palauans take life in stride. The challenge is to convince them to plan ahead in order to adequately prepare for potential extreme weather events (Kuartei, J, personal communication, September 24, 2010).

The location of the main hospital in Palau poses yet another threat as it is located very close to the ocean shoreline. Dr. Kuartei explains that the hospital is located where it is because it is “aesthetically pleasing.” However, one earthquake or a tidal wave could easily over-take the ward. He also explains that it is not just the hospital that is located close to the sea. Once the hospital was built, it became a magnet to other health entities, such as private clinics. In turn, if an extreme weather event were to occur, the hospital and many

of the secondary health facilities would be taken out. Palau has taken many steps to tackle this issue. Dr. Kuartei states how they have initiated “project uphill,” an effort to build new structures uphill to higher, safer grounds. He states that people are now very careful not to build houses near the sea, because people have seen the level rise throughout the years (Kuartei, J, personal communication, September 24, 2010).

Dr. Mark Keim explains that vulnerability to natural disaster has two sides: susceptibility and the exposure to dangerous hazards as well as resilience and the capacity to cope with or recover from such events. He also explains that “resilience has two components, those provided by nature, and those provided through human action” (2008, p. 509). He believes that “community based risk-reduction activities lessen human vulnerability to the vagaries of natural disasters that threaten public health” (2008, p. 515). Palau may not be protected by its surroundings, but benefits through human action. Dr. Kuartei states how the ability of Palauans to respond as a community is their greatest strength, not necessarily the government’s response to such disaster. The people of Palau are willing and able to be resilient to the effects of global climate change. However, he states that its biggest threat to health is lack of coordination. (Kuartei, J, personal communication, September 24, 2010).

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Climate Change MatrixC

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Crop damage: Salt water intrusion, flooding

Taro, Tapioca, Sugar cane, medicinal plants, dietary concerns

Adaptive capabilities: dietary education, cultural bonding

Flooding, Vector borne infections: Dengue, Malaria, Encephalitis

Populations close to the ocean, Koror hospital, Vector borne diseases

Readiness: Health education, higher awareness level

Unpredictable tides: Health access, flooding

Populations close to the ocean, mental health, health access

Readiness: Health education

Climatic event

Extreme heat

Results

Sea level rise

El Niño

Vulnerabilities/Increased Risks

Resiliencies

Crop damage: heat damage, drought, seasonal changes

Taro, Tapioca, Sugar cane, medicinal plants, dietary concerns, wildfires, safedrinking water

Adaptive capabilities: dietary education, preparedness, cultural bonding

Vector borne infections: Dengue fever, Malaria, Encephalitis

Developing country, resource poor, low-income populations

Readiness: Health education, alliance with more developed nations

Respiratory diseases: Chronic obstructive pulmonary disease, asthma, bronchitis

Elderly, isolated populations, health access, low-income populations

Readiness: Health education, higher awareness level

Heat-related illnesses: Syncope, cramps, exhaustion, dehydration, stroke

All populations: health access Readiness: Health education, higher awareness level

Coral damage Tourism (economy), Fishing Eco-friendly tourism: environmental education

Weakened Trade winds: warmer water

Fish distribution

Extreme weather: Droughts, floods, extended and shortened seasons,cyclones, typhoons

Vulnerable populations (location), farming, beach erosion, health access, emergency evacuations, cultural and historical sites (mental health)

Preparedness: education, readiness, redundancy

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Primary ResearchPart 1: Survey

Method:A ten-question survey designed to measure current awareness levels of climate change issues was

distributed among a sample size of 148 citizens of Palau between September 18th, 2010 and October 26th, 2010. Based on a population size of 20,000 citizens, the expected margin of error would be around 8%* with a confidence level around 95%**.

*The margin of error is the amount of error that you can tolerate. If 90% of respondents answer yes, while 10% answer no, you may be able to tolerate a larger amount of error than if the respondents are split 50-50 or 45-55. Lower margin of error requires a larger sample size.

**The confidence level is the amount of uncertainty you can tolerate. Suppose that you have 20 yes-no questions in your survey. With a confidence level of 95%, you would expect that for one of the questions (1 in 20), the percentage of people who answer yes would be more than the margin of error away from the true answer. The true answer is the percentage you would get if you exhaustively interviewed everyone. A higher confidence level requires a larger sample size.

Palau Climate Change Survey with Results1. How aware are you of global climate change in Palau?

a. Very aware Male: 27 Female: 39 Total: 66 45%b. Somewhat aware Male: 21 Female: 37 Total: 58 39%c. Slightly aware Male: 10 Female: 12 Total: 22 15%d. Not aware at all Male: 2 Female: 0 Total: 2 1%Question 1 Conclusion and Recommendations: Approximately 84% of the population surveyed range between

somewhat aware to very aware of climate change in Palau. 16% of the population was only slightly aware or not aware at all. Objectives should be set to increase the number of citizens at the “Very Aware” level.

2. How aware are you of the possible effects of global climate change on your health and wellbeing?a. Very aware Male: 24 Female: 39 Total: 63 43%b. Somewhat aware Male: 18 Female: 38 Total: 56 38%c. Slightly aware Male: 13 Female: 8 Total: 21 14%d. Not aware at all Male: 5 Female: 3 Total: 8 5%

Question 2: Conclusion and Recommendations: Approximately 80% of the population surveyed range between somewhat aware to very aware of climate change in Palau. 20% of the population was only slightly aware or not aware at all. Objectives should be set to increase the number of citizens at the “Very Aware” level.

3. How concerned are you about the possible effects caused by climate change on the health of Palauan citizens?a. Very concerned Male: 34 Female: 57 Total: 91 61%b. Somewhat concerned Male: 18 Female: 24 Total: 42 28%c. Slightly concerned Male: 6 Female: 6 Total: 42 8%d. Not concerned at all Male: 2 Female: 1 Total: 3 2%

Question 3: Conclusion and Recommendations: Approximately 90% of the population surveyed range between somewhat concerned to very concerned about possible health impacts caused by climate change. Only 10% of the population was only slightly concerned or not concerned at all. These results show the need to address the high level of concern among Palauan citizens about their health issues.

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4. How often are you exposed to information about global climate change?a. 4 or more times per month Male: 15 Female: 19 Total: 34 23%b. 2 – 3 times per month Male: 22 Female: 24 Total: 56 38%c. 1 time per month Male: 17 Female: 23 Total: 40 27%d. 0 times per month Male: 6 Female: 12 Total: 18 12%

Question 4: Conclusion and Recommendations: Approximately 39% of the population surveyed are exposed only 0 to 1 time per month to climate change information. It is key to increase levels of frequency and repetition of messages and information in order to raise awareness levels among the audience.

5. How much of a problem do you consider global climate change on the future of wellbeing of Palau?a. A major problem Male: 43 Female: 63 Total: 106 72%b. Somewhat of a problem Male: 14 Female: 19 Total: 33 22%c. A slight problem Male: 2 Female: 4 Total: 6 4%d. Not a problem at all Male: 1 Female: 2 Total: 3 2%

Question 5: Conclusion and Recommendations: 72% of the population surveyed consider global climate change to be a major problem on the future well being of Palau. Only 6% of the population considered it only a slight problem or not a problem at all. These results show the need to address the high level of concern among Palauan citizens about the future well being of Palau.

6. What do you consider the biggest communication problem when addressing the health impacts of climate change to your family, friends, and community?

a. A lack of awareness on the issues Male: 14 Female: 33 Total: 47 32%b. A lack of education on the issues Male: 16 Female: 21 Total: 37 25%c. A lack of concern about the issues Male: 20 Female: 20 Total: 40 27%d. A lack of evidence about the issues Male: 4 Female: 3 Total: 7 5%e. Other (please specify) ____________ Male: 6 Female: 11 Total: 17 11%

Question 6: Conclusion and Recommendations: Results were closely distributed when asked about the biggest communication problem when addressing health impacts of climate change. 32% of the population blamed a lack of awareness; 25% believed that a lack of education on the subject was at fault; 27% believed that a lack of concern was the biggest problem. The campaign should address all of these shortcomings.

7. Which public health aspect of climate change do you feel needs the most immediate attention?a. Security of drinking water Male: 14 Female: 23 Total: 37 25%b. Food security Male: 7 Female: 10 Total: 17 11%c. Saltwater intrusion of farmland Male: 13 Female: 14 Total: 27 18%d. Immunization against disease Male: 10 Female: 15 Total: 25 17%e. Emergency medical response Male: 5 Female: 12 Total: 17 11%f. Economic impact (tourism, fishing, etc) Male: 11 Female: 14 Total: 25 17%

Question 7: Conclusion and Recommendations: A wide range of beliefs about which public health aspect needs most immediate attention was also measured. 25% believe that secure drinking water is the most immediate concern; 18% believe saltwater intrusion of farmland; 17% economic impact on tourism and fishing; 17% immunization against disease, and 11% for both food security and emergency medical response. The campaign should address all of these health aspects.

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Primary Research cont’d

Interview Questions for Palau ProjectFishermen

1. How has climate change affected farming in Palau?2. Has there been any loss of farmland due to flooding, erosion, or saltwater intrusion?3. Are there any adjustments that Palauans have had to make in their farming methods due to climate change issues?4. Has the negative agricultural effects of climate change caused any dietary concerns in the health of Palauans?5. Have there been more cases of crop damage from flooding than in the past?6. Have there been more cases of crop damage from draught than in the past?7. Is there a fear that the farming industry might someday be ruined due to climate change?8. Are there food security issues in Palau due to global climate change?

Public Health Officials1. What health risks associated with global climate change are immediate concerns?2. What health risks in the future do you foresee stemming from global climate change?3. How well prepared is the health system of Palau to address the health issues caused by climate change?4. Have you made any changes to your health system in response to increased risks resulting from climate change, and if so, what are those changes?

Part 2: Personal InterviewsMethod:During a weeklong data-gathering trip to Palau, numerous personal interviews were conducted with fishermen, farmers, tourism experts, public health officials, and media experts. A consistent set of questions was used in order to monitor similarities and differences among people in the various industries. All interviews were recorded via video and audio.

5. What are the main constraints and obstacles in addressing the health issues related to climate change in Palau?6. What types of warning and evacuation plans are in place in Palau in case of extreme weather events?7. What are the threats to Palau’s water supplies due to saline intrusion or any other climate related event?8. How informed do you consider the general public of Palau on issues of global climate change in Palau?9. What climate change issue poses the greatest threat to Palauans?10. Are some Palauans more susceptible than others to health issues due to economic class, location, education, etc?11. Are there any waste management concerns related to global climate change?12. What are your thoughts on how Palau will develop in the next 100 years if global climate change keeps affecting the world?13. In the event of an extreme weather disaster, what type of programs does Palau have in place to ensure medical assistance (physical and mental) for citizens, speedy recovery, resilience of community, etc?14. Do you feel Palauan media addresses public health issues and information adequately?

Tourism1. With tourism rates on the rise in Palau, are there any concerns that climate change issues might impact tourism in the future?

Media1. How many households have television in Palau?2. How many households have radio in Palau?3. How many households have Internet in Palau?4. What is the most read magazine in Palau?5. What is the most read newspaper in Palau?6. Has there been previous ad campaigns related to global climate change in Palau?7. Are there billboards on the roads on Palau?8. Are there any non-traditional or alternative ways that Palauans get their information?

Conclusions and Recommendations: From the numerous interviews conducted we were able to find common responses and concerns from

a variety of people in similar professions. Information gathered from these interviews served as additional evidence in our decision making process.

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Key IdeaThe key idea for the campaign was developed

after conducting an interview with Palau’s Minister of Health, Dr. Stevenson Kuartei. According to Dr. Kuartei, the most vulnerable population in Palau is comprised of the healthy citizens. He explains that the healthy population must remain healthy in order to assist citizens who are less healthy or less capable of helping themselves. It is from this interview that we developed our key idea, “Protect, Provide, Unite.” Each word serves a purpose in raising the awareness of increased health risks due to climate change and also creates a memorable tagline for the campaign.

ProtectThrough primary and secondary research, it was

found that climate change has contributed to a rise in the number of vector-borne infections, respiratory diseases, heat-related illnesses, and dietary problems. The target audience is at a higher risk of exposure to vector-borne infections such as dengue fever, malaria, and encephalitis. Respiratory diseases are also on the rise among our target audience and include chronic obstructive pulmonary disease, asthma, and bronchitis. Heat-related illnesses include syncope, cramps, exhaustion, dehydration, and stroke. Individuals also face a greater risk of having dietary problems including diabetes and obesity.

While individuals are at a greater risk of exposure to certain health issues, protective measures can be taken to lower the risk of susceptibility and infection. Individuals should wear protective clothing, apply insect repellent frequently, and also use window screens to defend against many vector-borne infections. Protective measures can also be taken against respiratory diseases by developing a healthy

diet and removing themselves from exposure to air pollutants. Limiting the amount of time spent in extreme heat, drinking water regularly to prevent dehydration, and wearing protective clothing can aide in lowering the risk of heat-related illnesses. Regular visits to the doctor for check-ups will also help lower the risk for many of these diseases. In the event of a person being affected by any of the diseases, regular check-ups with a doctor could help catch and treat a disease early. Doctor’s also can encourage positive and healthy behaviors among individuals.

Through education on protective measures, we will be teaching individuals in the primary audience that protecting their own health is making an investment into the health and well-being of all Palauan citizens. This initiative leads us to the second part of the key idea, “Provide.”

ProvideWhen individuals have protected themselves,

they can then provide help and assistance to family, friends, and the community. By providing assistance to others, the primary audience will aide in lowering the risk and susceptibility of other individuals to certain health issues. The education that the primary audience gains on health risks related to climate change and the ways to lower the risks will be passed on to future generations of Palau, providing a safer and healthier environment to live in.

The second part of the key idea seeks to provide assistance to others while bringing the primary and secondary audience together. The act of coming together symbolizes the already strong sense of community that exists in Palau. Ultimately, this lead to the final piece of our key idea, “Unite.”

UniteThrough the process of protecting and providing

education and assistance to others, we are uniting all citizens for a healthier Palau. Again, the idea that individuals must protect themselves first empowers them with the ability and knowledge to provide assistance to the less fortunate and to unite the community. Increasing unity among individuals should raise awareness about the health risks associated with climate change among all audiences.

All three words serve a separate purpose, but all three words need to exist together to be effective. The three words behind our key idea will be incorporated into all of our creative.K

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Target Market ProfileBased on the analogy that was provided by

Dr. Kuartei, we chose two target audiences for the campaign. The primary audience we are targeting with our campaign is healthy Palauan citizens both male and female between the ages of sixteen to sixty-five years old. According to Palau census data, 13,270 individuals of the population account for this age range. The data also showed us that 68% of this audience resides in Koror, with the average household size being four persons. The primary audiences average household income is $11,117.68 with the majority of this income coming from public sector work. These individuals spend the largest portion of their income, roughly 20%, on miscellaneous expenses, which are expenses that do not fall under the general categories of rent, household expenses, food, leisure, or transportation.

Our primary target audience also engages in many informal activities. The most common activities include farming, food preparation, fishing, and woodcarving. While farming contributes to a significant amount of the food supply for this audience, many continue to shop at local stores. For regular grocery needs, many in this audience visit WCTC Shopping Center and Surangels, both located in Koror. Individuals also shop at Yano, a market that supplies locally grown foods. The primary audience utilizes radio, newspapers, and television to receive their information. Although very few radio stations exist in Palau, this audience uses radio

frequently, most listen to Diaz Broadcasting, 89.5 FM. Our primary audience also obtains their information from the three local newspapers; Island Times, Palau Horizon, and Tia Belau. Of the 11,000 televisions in Palau, 5,000 households subscribe to the digital cable network, Palau National Communication Corporation (PNCC). Our primary audience mostly accesses the four local channels broadcasted through PNCC, specifically Channel 23, Oceania Television Network, and Channel 26, Diaz Broadcasting.

The secondary audience we chose for the campaign is children and adolescents ages eight to fifteen years old. This audience accounts for 4,888 individuals of the total population. We have selected this audience because we recognize them as the future of Palau. Starting education about the health risks associated with climate change with a young audience will allow the campaign to have an even greater impact and extend past its six-month parameters.

Our secondary audience uses most traditional media and has been joining social media sites such as Facebook in recent years. Our secondary audience uses radio to receive information and listens to 88.9 KRFM most often. This radio station is among the most popular based on its broadcast of current music, playing both American and Palauan songs. The local television stations are among the most watched in Palau with Oceania Television Network and Diaz Broadcasting being the most popular.

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Media Objectives1.

Reach 75% of the primary target audience five times per month during the six-month campaign.Rationale: The key to raising awareness levels lies in frequency of exposure. Our primary audience needs to be exposed to our message often in order to motivate them to action.

2.Reach 85% of the secondary target audience three

times per month during the six-month campaign.Rationale: Raising the awareness level among a younger audience helps insure a healthier future for Palau and helps raise awareness among the children’s family members, friends, and community.

Communication Objectves1.

Increase awareness level to 75% of the primary target audience (healthy citizens of Palau) about the need to protect themselves against the increased health risks associated with climate change. This will be accomplished within the first half of the six-month campaign.Rationale: Dr. Kuartei’s statement that healthy Palau citizens are the most vulnerable creates a need to raise awareness levels among this audience.

His analogy of the airline procedure with oxygen masks (you must first make sure your own mask is in place and working properly; then you can assist others) helps solidify this objective and rationale.

2.Increase awareness level to 80% of the

secondary target audience about the need for them to be the “future healthy generation” of Palau. Increase awareness that there is a need to protect themselves, their families, friends, and community against increased health risks associated with climate change. This will be accomplished within the six-month campaign.Rationale: Teaching future generations to protect themselves first, so that they are then able to provide assistance to others and education about the increased health risks associated with climate change. This is important in ensuring a healthy future for citizens of Palau.

Advertising Objectves1.

Establish in the minds of 75% of the two target audiences that protecting their own health in order to provide assistance and education to others is an investment into the health and well being of all Palauan citizens. This will be accomplished during the first half of the six-month campaign.Rationale: Dr. Kuartei’s analogy of airline procedure with oxygen masks (You must first make sure your own mask is in place and working properly; then you can assist others).

2.Establish top-of-mind awareness

in 80% of the two target audiences that there are increased levels of health risks that are associated with certain aspects of climate change. This will be accomplished during the first half of the campaign.

Rationale: Our primary research shows that 61% of Palauan citizens surveyed are very concerned about the possible health effects caused by climate change events. (Survey question 6)

3.Reinforce in the minds of 75%

of the two target audiences that climate change is related to certain health issues in Palau. This will be accomplished during the second half of the six-month campaign.Rationale: Our primary research shows that 57% of Palauan citizens surveyed consider a lack of awareness and education about climate change the biggest problem when addressing health impact issues with family, friends, and community. (Survey question 9)

(What the campaign should accomplish)

(What the message should accomplish)

(What the selected media should accomplish)

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Advertising and Media StrategyA variety of media will be implemented in order

to raise awareness among our target audiences about health risks associated with climate change. A media mix of newspapers, television, radio, billboards, posters, informational brochures, social media, special climate change events, direct mail, and promotional items are utilized to obtain the frequency of exposure needed to raise awareness levels to meet the established goals.

Timing and ad scheduling will be arranged so that logo and tagline awareness is raised prior to the more individualized messages being released. The heart of this media plan is based around frequency of exposure to Palauan citizens. One exposure of an advertisement to a target group has little or no effect. After three exposures within a campaign cycle and the more frequency increases, the more advertisements become effective.

Wear-out of an advertising campaign is not caused by too much frequency but is more related to copy and content problems. Therefore, content will be changed regularly in order to keep things fresh.

Logo strategyThe logo uses the traditional Palauan flag colors

of blue and yellow and contains the words “Protect, Provide, Unite.” A circular arrow is used to encompass the three words to unify the “key idea.” The logo will be placed in prominent locations in all of the print and television advertisements. Visual frequency and repetition of the logo will create familiarity with the key idea. In radio advertisements where the logo cannot be seen, the tagline will be recited.

In order for the audiences to better understand the logo’s meaning, a series of advertisements are used that introduce each word of the tagline through the use of powerful images and explanations. With repetition, seeing the logo should trigger a mental connection between health risks and climate change. Also, the active tagline, “Protect, Provide, Unite” encourages behavior change and modification among our audiences. Logo recognition is critical in creating campaign awareness.

NewspapersNewspaper Advertising Strategy

Newspaper advertisements have been categorized into three series:Series 1: Checklist Ads

During the first month of the campaign, a page positioning strategy will be utilized in all three newspapers. There will be two, 3 (column) X 9 (inch)

(this size dominates the page without having to buy the full page) ads that line up behind each other on corresponding pages. For example, the first ad would be placed on the bottom right hand side of page three and the second ad would be the same size placed on the bottom right hand side of page five. The first ad (page 3) would show a checklist of health issues related to climate change. The question used in the ad would ask, “Which of the following health risks do you believe increases with climate change events?” There will be boxes to check beside each response so the reader can respond to the list. When the page is turned (to page 5) there is an identical ad, except all of the boxes have bright red (spot color) check marks, showing that all of the responses are actually increased health risks. The bright red spot color will be used on an otherwise black and white page. The advertisement’s forward placement in the newspaper, along with the use of the bright red spot color will increase recognition of the ad. Series 2: Logo Ads

During the first month of the campaign, four full-page (5 column X 16 inches), full color ads will be placed to introduce the campaign logo. One ad will appear each week and will rotate among the three newspapers so as to not overlap with series one ads. During the first two weeks of the second month of the campaign, six full-page (5 column X 16 inches), full color ads will be placed. This allows for one of these ads to run in each newspaper once per week for the first two weeks of the second month of the campaign. The logo ads will also be used at strategic times throughout the remaining months of the campaign as a reminder of the mission of the campaign. These ads will show the campaign logo in full color. The ad copy below the logo will be used to explain the “Protect, Provide, Unite” tagline to the readers. During the first two weeks of the campaign’s second month, these ads will be used to establish familiarity with the logo and tagline. These ads will also be mixed into the scheduling during the latter half of the campaign for reinforcement of the key idea. Series 3: Fact Ads

Also, during the second month of the campaign, a series of more individualized newspaper ads will begin to be placed. These ads will be black and white, 3 (column) X 8 (inch) in size with a page 3 placement in each of the three newspapers. Each ad in this series will state facts that relate to the health risks associated to


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Strategy cont’dclimate change. Each ad will individualize a word from the tagline, Protect, Provide, Unite, and employ the fact strategy to a variety of climate related health risks. The ads will create awareness of health related issues and their association with climate change. The ads are also designed to educate the reader on various actions they can take to help lessen the impact or prevent these health issues. There will be nine different ads in this series that will be strategically mixed among the three different newspapers. Duplicate ads will not run in any of the three newspapers during the same week. The creative elements in these ads will display continuity, but will address different subject matter within each. All ads will contain the campaign logo and tagline.

Newspaper Media StrategyThe largest portion of the campaign’s advertising

will be through newspapers. There are three major newspapers that serve Palau and they are: Island Times, Palau Horizon and Tia Belau (This is Palau). Each newspaper has a circulation of about 1,200 copies each with Island Times and Palau Horizon publishing twice a week, while Tia Belau only has a weekly issue. The Island Times and Palau

Horizon are both published on Tuesdays and Fridays while Tia Belau is published every Monday. All three newspapers are sold throughout Palau from Babeldaob in the north, to Angaur in the south. Because of the limited media in Palau, readership is high across all three newspapers.

All three newspapers are tabloid-sized format and sixteen pages in length. Mechanically, they are all five-column formats with full-color available only on front and back pages and the double-truck (pages 8-9). Spot colors are available on certain pages (2, 7, 10, and 15) for additional costs.

During the first month of the campaign, the series 1 ads (checklist ads) will run in two papers per week (Island Times, Palau Horizon), while the third paper (Tia Belau) runs the series 2 (full page, full color logo) advertisement. This plan rotates the ads between each of the three papers each week, during the first month.

During the second month of the campaign, the same strategy will be used except during this month the series


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Strategy cont’d2 ads (full page, full-color logo) will run in two papers per week (Island Times, Palau Horizon), while the third paper (Tia Belau) begins to run series 3 (fact) advertisements. This plan rotates between each of the three papers each week, during the second month.

During the remaining four months of the campaign, a mixture of all three series (series 1, 2, and 3) of print ads will run with a new ad being introduced into the mix each month to prevent consumer wear out. The three papers will not contain the same ad during any week of the final four months of the campaign.

TelevisionTelevision Advertising Strategy

Television ads have been designed to follow the idea of stating facts. The commercials are 60-seconds long, but can also be edited to 30-second commercials. Each commercial uses eye-catching images that contain real footage gathered during primary research. When individuals see a commercial with images of people they may know, it resonates with them more and urges them to apply the message from the commercials to their own lives.

The facts that we chose to present in the commercials will be displayed on the screen for viewers to read. The typeface that is used in the commercials is consistent with the typeface used throughout other aspects of the campaign. While we incorporate background music that suggests the seriousness of our message, the music used will not make our message feel morbid or frighten audiences. After all of the chosen facts have been represented through the commercial, the commercial will come to an abrupt end, with our logo covering the entire screen. Having the logo appear in the television commercials allows viewers to associate the logo with the campaign message and identify with the other mediums they encounter..

Television Media StrategyPalau National Communications Corporation

(PNCC) is the only television broadcasting company in Palau. With 11,000 televisions on the island, there are only 5,000 households that actually subscribe to PNCC. Through PNCC, there are four local channels that are broadcasted. We have selected the two most popular local television channels to advertise on, Oceania Television Network (OTV), channel 23 and Diaz Broadcasting, channel 26.

Commercial placement is important in ensuring we reach our audiences at the right time and also

the right number of times to convey the campaign message. The 60-second television ads will first appear during prime time (Oceania prime time is considered 6:00 p.m. – 10:30 p.m.) view twice an evening on both channels during the first two months of the campaign. Ads will appear everyday for the first two months mostly after the local news. Only one 30-second commercial would begin to be introduced as the second month of the campaign is coming to a close. The 60-second commercials would still appear over the course of the campaign, just not as frequently. After the third month of the campaign, we will begin using the additional 30-second commercial so the ads do not seem repetitive. We will rotate these commercials throughout the campaign, having them aired mostly in the evening.

RadioRadio Advertising Strategy

Only the most important facts that easily translate into images in the listener’s mind are used in the radio advertisements. The radio ads are kept simple and to the point so as to not create confusion about the message. The radio ads will be similar to other elements of the campaign and will state facts throughout. The facts recited in the commercial will be about health risks related to climate change and


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Strategy cont’d

also about protective measures. Ads will also feature engaging sound effects that encourage listeners to stay tuned to the station. All radio advertisements will end with the message “Protect, Provide, Unite” being recited. Although, we are not able to visually display our logo through radio, verbal repetition on a frequent basis can also be an affective memory reinforcement tool.

Radio Media StrategyRadio is a frequently used medium in Palau.

There are four local radio stations, but only three will be used in the campaign. Diaz Broadcasting/WWFM 89.5, KRFM 88.9 MHz, and the government owned station, Eco-Paradise FM/Voice of Palau that broadcasts simultaneously on 87.9 MHz and 1584 AM are the three local radio stations where advertisements will be placed. Each station reaches a variety of listeners and placing advertisements on each station will help expand on reach goals.

Given the large number of people driving to and from work every day, both morning (6-10 a.m.) and evening (3-7 p.m.) drive times are utilized to reach the primary target audience. To retain campaign continuity, two 30-second radio advertisements have been developed that feature the “fact” theme. The ads will alternate during the morning and evening drive times. The two radio advertisements will alternate every day between the three stations (336 radio ads per month). Two ads will air during morning drive time hours and also during the evening drive time, throughout everyday and every week of the campaign. New radio advertisements will be

inserted into the mix monthly to retain freshness.

BillboardsBillboard Advertising StrategyBillboard strategy will be similar to other

mediums and will state facts to create a feeling of continuity with the other ads in the campaign. The billboards will also contain minimal copy to ensure the message can be read quickly by passing traffic. Some billboards will contain an eye-catching image that relates to the health risk that the road sign is representing.

We will also break the border of every billboard with either the campaign logo or a checkmark. Two of the six billboards will be rotated so they stand vertically instead of horizontally. The first vertical billboard will feature the same checklist that appears in the series one newspaper ads. The second vertical billboard will feature the circular logo mounted at the top, with the logo extending past the top and side edges. Beneath the logo, the billboard will have the extended tagline that reads, “Protect yourself, Provide assistance to others, Unite for a healthier Palau.”

The remaining billboards will be horizontal and will feature a fact and checkmark that extends past the border. The campaign logo will also appear on the billboard and extend to the outside as well. Each of the horizontal billboards will display a fact as well as an image that corresponds with the fact.

Billboard Media StrategyBillboards are small in size, but a very important

medium in Palau. The standard size for all Palau billboards is 8 feet by 4 feet. Most of Palau’s billboards are located on Compact Road, the main road of Palau. There are also numerous billboards on secondary roads located throughout the country. There are approximately 50 to 75 billboards in Palau. This campaign would utilize 20 – 25 of these signs during the six-month campaign. Strategic placement of signs will yield a high amount of impressions by vehicular traffic as well as by pedestrian traffic. The largest number of billboards will be placed in and around the Koror area due to a denser population and high amount of traffic traveling to and from work on a daily basis. Although only 20-25 of Palau’s billboards will be utilized, billboard messages will be changed monthly to prevent wear out.


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Strategy cont’d

PostersPoster Advertising Strategy

Two varieties and sizes of posters will be utilized during the campaign. The first poster style will follow the format of the series 3 (fact) newspaper ads. Posters following this format will be 8.5 inches by 11 inches in size and full color. There are nine different versions of posters in this format. The second style poster follows the road sign format and will be 17 inches by 11 inches in size. Full color will be utilized in order to draw readers’ attention to the posters. There are four different versions of this poster format.

Poster Media StrategyBy implementing posters into the campaign, both

primary and secondary audiences can be reached. Certain audience members who might not be exposed to billboards would stand a higher probability of exposure through strategically placed posters. We will print one-thousand copies of each poster. The posters would be placed both indoors and outdoors in every state in the country, therefore, reaching isolated populations, such as Kayangel and Peleliu. Indoor areas, such as the hospital, dispensaries, clinics, schools, health and fitness facilities, grocery and retail

outlets, meeting locations, etc, will be utilized. Also, strategic outdoor locations will be used during special events.

Brochure Advertising and Media Strategy

Brochures will be used to provide Palauan’s with recent and relevant information designed to educate them about the public health risks of climate change. Brochures are designed in a tri-fold format and will use full color images of local places and people. Brochures will contain preventative or protective health measures and information that address health issues related to climate change. A different brochure will be printed each month of the campaign and will address a different topic. The first month of the campaign a cyclone preparedness brochure will be distributed. Other brochures that will be distributed over the course of the campaign will address preparedness measures for vector-borne infections, diet and diabetes, sea level rise and crop damage, extreme heat and crop damage, and finally, extreme heat and protective health measures.


One-thousand brochures will be printed each month. Brochures will be distributed at the events aimed at our target audiences (Palasia Hotel event and the children’s camp). Brochures will also be available as they are released each month through the hospital, clinics, dispensaries, Ministry of Health, and any other strategic location or event that is determined at a later time.

Social MediaAdvertising andMedia Strategy

The website will contain information regarding the campaign, as well as useful health tips and guidance, FAQs, contact information, and message boards. The website does not contain rich media or anything that would contribute to a slower page download.

Although Internet access is limited in Palau, user data suggests that it is a growing medium in the country. Data shows that there were 5,400 Internet users as of December 2007 or 26% penetration. There were 2,860 (13.8%) Facebook subscribers in Palau as of August 31, 2010. The cost is very inexpensive at only $0.21 per click. Clickable advertising banners appearing only on the pages of Palauan Facebook subscribers will direct traffic to the website created especially for the campaign.

Event StrategyYearly Climate Meeting

The event recommended to reach the primary audience (14,241) is a re-creation of the September

2010 climate change meeting in Koror at the Palasia Hotel. Invitations will be sent via direct mail to state government and public health officials, teachers, and other parties of interest.

The half-day event will be scheduled during the opening month of the campaign in April 2011. A campaign launch coordinated with Earth Day is suggested. The meeting will begin with morning presentations from local climate, health, and tourism experts. A lunch will be served to all those attending and will be followed by a group discussion and interaction. A tote bag containing the campaign promotional materials will be placed at every table setting and available for all those attending. A DVD containing interviews, question and answer sessions, and photos obtained during SIU’s visit to Palau will be among the promotional materials. Closing statements and dismissal would conclude by early afternoon.

Children’s CampClimate Exercise

The events directed toward the secondary audience (4,888) are in addition to the children’s camp that already takes place during three weeks of summer. The camp schedule is as follows: June 13th – 17th at Ngcremlengui, June 20th – 24th at Mclckcok, and June 27th – July 1st at Koror. The Ministry of Health and the Governor’s Association fund these informational camps for children ages 8-16. During each of these camps, a half-day of team-building exercises, fun informational sessions, and games and contests about global climate change will be conducted. In addition, campaign t-shirts, coloring books featuring health topics, and a variety of campaign promotional items will be given to each participant. Team building events such as: Climate Change Jeopardy and a raft-building contest. A tour around Palau will be designed to show children the effects of their environment caused by climate change.

Climate ChangeAwareness Day

Another secondary audience event will be held at the local schools. A climate change informational day is highly recommended for this campaign. Inviting guest speakers from a variety of related fields will further educate children about public health and global climate change. Throughout the day teachers and staff will come together for planned activities S

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Strategy cont’drelated to climate change and public health.A few suggested exercises include:

A contest where the kids individually draw their own interpretation of what “Protect, Provide, Unite” means to them and hang the final drawings where everyone can see them.

Class photographs of the children wearing their campaign t-shirts would be taken and given to them as a reminder of the event.

A nutrition expert will teach good eating habits as well as dietary issues related to climate change events.

The school informational day will be a good opportunity to hand out t-shirts, brochures, and promotional materials. This will also reach the children who did not attend the summer camp and provide additional exposure to the ones that did attend. The informational brochures and promotional materials will be something the children can take home to their parents at the end of the day.

Direct Mail StrategyBecause of postal limitations, direct mail is not one

of this campaign’s most important mediums. There are also no actual street addresses in Palau, so there is no residential mail delivery. There are a limited number of post office boxes available at the post office in Koror. Mail to outlying islands is usually addressed to the state’s government office where Palauans can receive their mail.

A direct mail piece will be used as an invitation to the climate change event at the Palasia Hotel in April 2011. The invitation will display the campaign logo on the front. The reverse side will reveal full details about the event held at the Palasia Hotel on the Saturday after Earth Day.

Promotional Material Strategy

All promotional items were selected based on their ability to carry the campaign message and logo as well as being usable products that directly relate to the campaign subject matter.

T-‐Shirts: 20,000T-shirts are a very important element of this

campaign. When individuals wear the shirts they will serve as walking billboards.

The t-shirts will be a light blue, similar to the color on the Palauan flag and also have yellow and white writing. The t-shirts will feature the campaign logo on the front and have an explanation of “Protect, Provide, Unite” on the back. The lighter color of the shirt will help deflect sunlight as well as display colors closely affiliated

with Palau. Children’s sizes as well as adult sizes will be available.

The t-shirts will be distributed strategically throughout the campaign to help supplement its various events and promotions.

The overall goal for the t-shirts is to use a minimal to no-cost advertising medium with a long shelf life to assist in creating and retaining awareness about the effects of climate change on the public heath of the Palauan people.

Several sponsors will be approached and asked to donate to the campaign to cover the costs of the t-shirts.

Ideally every Palauan will proudly wear a “Protect, Provide, Unite” t-shirt and to aid in reiterating the campaign message.

Tote Bags: 1,000Tote bags will also be distributed. These were

selected because they are eco-friendly, reusable, and convenient in that they can hold all of the other promotional items. Tote bags also have a large area to display the campaign logo and message. Individuals carrying or shopping with the tote bag will help with exposure and retention goals.

Reusable water bottles: 1,000Water bottles were selected because they are a

constant reminder for people to stay hydrated. The water bottles, like other promotional items will feature the campaign logo and message, helping with exposure and retention goals.

Fly Swatters: 1,000Fly swatters were selected to provide and serve as

a link to simple preventative measures of insect control. They will also display the campaign logo.

Bandanas: 1,000Bandanas were chosen because they serve a

purpose in sun protection and are popular in Palauan culture. The bandanas are designed to display a repetitive pattern of campaign logos.

Sweatbands: 1,000Sweatbands were selected based on their usability

in a hot climate. They can also be used during athletic events. They will again display the campaign logo and help with exposure.

Baseball Caps: 1,000Baseball caps provide protection from extreme

sun exposure. They also provide another opportunity for displaying the logo. Similar to the t-shirts, when individuals wear baseball caps, they will serve as walking billboards.

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BudgetBudget Allocation

Budget Estimates

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Budget cont’dPromotional Items Budget Allocation

Promotional Items Budget Estimates

This budget reflects the costs that would be incurred if all mediums were implemented. Promotional items have the potential to be sponsored. Palau media outlets can also be approached for media donations.

EvaluationAssessment of this campaign is scheduled for

October 2011. At this time, Department of Health employees will administer a survey containing the same questions as the first survey administered in Palau, October 2010. One question will be added that measures the awareness of the “Protect, Provide, Unite” campaign. The sample will be randomly

selected and the sample size will be at least 148 (the size of the first sample) respondents.

Once data is gathered and analyzed, comparisons will be made between the results of the first and second survey. Comparing the results of each question will indicate how much awareness levels have changed between October 2010 and October 2011.

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Agency 1244 has created a campaign that is engaging and designed to effectively achieve the established objectives. The “Protect, Provide, Unite” campaign resonates with the target market because it was created with the target market. Being able to

evaluate the campaign following the six-month plan, will also allow us to know whether or not we have raised the level of awareness among Palauan’s and equipped individuals with the knowledge they need to “Protect, Provide, Unite.”

Conclusion

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References

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References cont’dProjectedHealthImpactsThurston.pdf - Powered by Google Docs. (n.d.).. Retrieved October 26, 2010, from http://docs.google.com/viewer?a=v&q=cache:PY7HP59e1G4J:www.co.thurston.wa.us/health/admin/initiatives/PDF/ProjectedHealthImpactsThurston.pdf+Planning+for+Health+Consequences+of+Climate+Change&hl=en&gl=us&pid=bl&srcid=ADGEESi0DaDpqJUtJfm3GCCpvLj2DPk2oJ-TYFOO_uV3eov9sd12FI-MbJwJb37Y3CgnHDm8InThB3Gi7MapOv80KL48gE1deRzfpwulb1rCs5bbrnOIgoeOsydrRL6X0x1FEt41Cg2I&sig=AHIEtbR1AkyL3Ex8klJ3sHw__hedTZhweQ”\t“_blank” http://docs.google.com/viewer?a=v&q=cache:PY7HP59e1G4J:www.co.thurston.wa.us/health/admin/initiatives/PDF/ProjectedHealthImpactsThurston.pdf+Planning+for+Health+Consequences+of+Climate+Change&hl=en&gl=us&pid=bl&srcid=ADGEESi0DaDpqJUtJfm3GCCpvLj2DPk2oJ-TYFOO_uV3eov9sd12FI-MbJwJb37Y3CgnHDm8InThB3Gi7MapOv80KL48gE1deRzfpwulb1rCs5bbrnOIgoeOsydrRL6X0x1FEt41Cg2I&sig=AHIEtbR1AkyL3Ex8klJ3sHw__hedTZhweQ

Republic of Palau (2007). Business Opportunities Report. Island Business Opportunities.

Republic of Palau (2010). Dengue Fever. Ministry of Health.

Republic of Palau (2005). Health facts & figures brochure. Ministry of Health.

Republic of Palau. (2002). National report to the United Nations convention to combat desertification. Republic of Palau. Office of Environmental Response and Coordination.

Republic of Palau (2010). Obesity facts. Ministry of Health.

Republic of Palau. (2007). Retrieved from http://www.raconline.org/states/palau.php

Sample, I. (2006, May 4). Trade winds weaken with global warming. Retrieved from http://www.guardian.co.uk/environment/2006/may/04/science.weather

Shah, A. (2010). Coral Reefs. Global Issues. Retrieved from http://www.globalissues.org/article/173/coral-reefs

Sir gilbert walker. (n.d.). Retrieved from http://www.weatheronline.co.uk/reports/weatherbrains/Sir-Gilbert-Walker.htm

Syncope. (n.d.).. Retrieved October 26, 2010, from http://www.americanheart.org/presenter.jhtml?identifier=4749

Than, K. (2006, May 3). Global warming weakens pacific trade winds. Retrieved from http://www.msnbc.msn.com/id/12612965/

Tsai, H. T., & Liu, T. M. (2005). Effects of global climate change on disease epidemics and social instability around the world. Human Security and Climate Change, 21–23.

United States Global Change Research Program (2009). Island communities, infrastructure, and ecosystems are vulnerable to coastal inundation due to sea-level rise and coastal storms. Retrieved October 13, 2010 from http://www.globalchange.gov/publications/reports/scientific-assessments/us-impacts/full-report/regional-climate-change-impacts/islands

U.S. Climate Change Science Program. January 2009: Regional Climate Impacts: Islands. Retrieved October 20, 2010 from http://downloads.climatescience.gov/sap/usp/prd2/usp-prd-islands.pdf\

West, L. (2010). About.com. Retrieved October 21, 2010, from What are the effects of drought?: http://environment.about.com/od/environmentalevents/a/droughteffects.htm

World Health Organization. The World Health Report 2003 – Shaping The Future. Retrieved October 20, 2010 from http://www.who.int/whr/2003/chapter1/en/index2.html

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CreativeNewspaper: Series 1 Checklist Ads

Append

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Creative cont’dNewspaper: Series 1 Checklist Ads

Appen

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44

Creative cont’dNewspaper: Series 2 Logo Ads

Append

ix

45

Creative cont’dNewspaper: Series 3 Fact Ads

Appen

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Append

ix

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Creative cont’dPalau: 60 Second Television Spot

MUSIC: Generic InstrumentalSFX: Swishes of the animationStart off with moving pictures of Palau.

Every statistic used will be titled “FACT.”

The text will be active and moving in a variety of directions across the screen. To transition between facts, the shot will zoom in and out, utilizing the current letters as the background for the next set of infromation.

Photos gathered during primary research will be used. The pictures correspond with the facts that are displayed.

The color scheme will follow a simple black, white, and yellow pattern as seen throughout the campaign. Yellow is used as a spot color to create emphasis.

Photos appear sporadically throughout the commercial and are transitioned by quick movements of the actual photo itself.

After a fact, transitions will appear on the screen for 4-5 seconds. The facts will cover mosquitoes, dengue fever, sea level, and diabetes problem.

The “Protect, Provide, Unite” logo will be displayed at the end. It will fade out at the end of the commercial.

Append

ix

55

Creative cont’dRadio

Appen

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56

Creative cont’dBillboards

Which of the following health risks do youbelieve increase with

climate change events?

Dengue fever

Malaria

Encephalitis

Pulmonary disease

Asthma

Bronchitis

Cramps

Exhaustion

Dehydration

Stroke

Append

ix

57


Protectyourself

Provideassistanceto others

Unitefor a healthier

Palau

www.PalauClimateChange.com

Appen

dix

58


Tropical cyclone activity is predicted to increase within the twenty-first century.


Crop damage related to climate change events is linked to the rise in cases of diabetes.


Append

ix

59


Mosquitoes carry harmful diseases.www.PalauClimateChange.com

Staying hydrated helps prevent heat-related illnesses.


Appen

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Creative cont’d17 X 11 Posters

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ix

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Creative cont’d17 X 11 Posters

8.5 X 11 Posters on pages 62-‐70

Append

ix

71

Creative cont’dDirect Mail

Brochure

Appen

dix

72

Creative cont’d

Are

you

pre

pare

d for

a c

yclone

?

Wha

t to

do b

efore

cy

clone

sea

son

Chec

k w

ith y

our l

ocal

cou

ncil

or y

our b

uild

ing

cont

rol a

utho

rity

to s

ee if

you

r ho

me

has

been

bu

ilt t

o cy

clon

e st

anda

rds.

Chec

k th

at the

wal

ls, r

oof a

nd e

aves

of y

our

hom

e ar

e se

cure

.Tr

im t

reet

ops

and

bran

ches

wel

l cl

ear

of

your

hom

e (g

et c

ounc

il pe

rmis

sion

).Pr

efer

ably

fit

sh

utte

rs,

or

at

leas

t m

etal

sc

reen

s, t

o al

l gla

ss a

reas

.Cl

ear

your

pro

pert

y of

loo

se m

ater

ial

that

co

uld

blow

abo

ut a

nd p

ossi

bly

caus

e in

jury

or

dam

age

durin

g ex

trem

e w

inds

.In

cas

e of

a s

torm

sur

ge/t

ide

war

ning

, or

ot

her

flood

ing,

kno

w y

our

near

est

safe

hig

h gr

ound

and

the

saf

est

acce

ss r

oute

to

it.Pr

epar

e an

em

erge

ncy

kit

cont

aini

ng:

a po

rtab

le

batter

y ra

dio,

to

rch

and

spar

e ba

tter

ies;

wat

er c

onta

iner

s, d

ried

or c

anne

d fo

od

and

a ca

n op

ener

;mat

ches

, fu

el la

mp,

por

tabl

e st

ove,

coo

king

gea

r, ea

ting

uten

sils

; an

d a

first

ai

d ki

t an

d m

anua

l, m

aski

ng t

ape

for

win

dow

s an

d w

ater

proo

f ba

gs.

Keep

a lis

t of

em

erge

ncy

phon

e nu

mbe

rs o

n di

spla

y.Ch

eck

neig

hbor

s, e

spec

ially

if re

cent

arr

ival

s,

to m

ake

sure

the

y ar

e pr

epar

ed.

Wha

t to

do w

hen

the

cyclone

strikes

Disc

onne

ct a

ll el

ectr

ical

app

lianc

es. L

iste

n to

yo

ur b

atte

ry r

adio

for

upd

ates

.St

ay in

side

and

she

lter {

wel

l cle

ar o

f win

dow

s)

in the

str

onge

st p

art of

the

bui

ldin

g, i

.e. c

ella

r, in

tern

al h

allw

ay o

r ba

thro

om.

Keep

eva

cuat

ion

and

emer

genc

y ki

ts w

ith y

ou.

If th

e bu

ildin

g st

arts

to b

reak

up,

pro

tect

you

rsel

f w

ith m

attres

ses,

rugs

or b

lank

ets

unde

r a s

tron

g ta

ble

or b

ench

or

hold

ont

o a

solid

fixt

ure,

e.g

. a

wat

er p

ipeB

ewar

e th

e ca

lm ‘

eye’

. If

the

win

d dr

ops,

don

’t as

sum

e th

e cy

clon

e is

ove

r; vi

olen

t w

inds

will

soo

n re

sum

e fro

m a

noth

er d

irect

ion.

W

ait fo

r th

e of

ficia

l ‘al

l cle

ar’.

If dr

ivin

g, s

top

(han

dbra

ke o

n an

d in

gea

r) -

but

wel

l aw

ay fr

om th

e se

a an

d cl

ear o

f tre

es,

pow

er

lines

and

stre

ams.

Sta

y in

the

vehi

cle.

Wha

t to

do a

fter

the

cy

clone

strikes

Don’

t go

outs

ide

until

offi

cial

ly a

dvised

it is

saf

e.Ch

eck

for

gas

leak

s.

Don’

t us

e el

ectric

ap

plia

nces

if w

et.

Liste

n to

loc

al r

adio

for

offi

cial

war

ning

s an

d ad

vice

.If

you

have

to e

vacu

ate,

or d

id s

o ea

rlier

, don

’t re

turn

unt

il ad

vise

d. U

se a

rec

omm

ende

d ro

ute

and

don’

t rus

h.Be

war

e of

da

mag

ed

pow

er

lines

, br

idge

s,

build

ings

, tre

es, a

nd d

on’t

ente

r floo

dwat

ers.

Heed

all

war

ning

s an

d do

n’t

go s

ight

seei

ng.

Chec

k/he

lp n

eigh

bors

inst

ead.

Don’

t mak

e un

nece

ssar

y te

leph

one

calls

.**A

dapt

ed fro

m h

ttp:

//w

ww

.jcu.

edu.

au/e

mer

genc

y/cy

clon

e/JC

UDEV

_005

415.

htm

l

ww

w.P

alauC

limate

Cha

nge.

com

Append

ix

73

Creative cont’dW

hat is a

cyc

lone

?

How

to p

rote

ct y

our

hom

eTh

e m

ost im

port

ant pr

ecau

tion

you

can

take

to

red

uce

dam

age

to y

our

hom

e an

d pr

oper

ty

is t

o pr

otec

t th

e ar

eas

whe

re w

ind

can

ente

r. Ac

cord

ing

to r

ecen

t w

ind

tech

nolo

gy r

esea

rch,

it’

s im

port

ant

to s

tren

gthe

n th

e ex

terio

r of

you

r ho

use

so w

ind

and

debr

is d

o no

t te

ar l

arge

op

enin

gs in

it. Y

ou c

an d

o th

is b

y pr

otec

ting

and

rein

forc

ing

thes

e fo

ur c

ritic

al a

reas

:•

The

roof

and

wal

ls,

• Th

e w

indo

ws

and

door

s, a

nd•

The

gara

ge d

oor(

s).

• If

you

are

in a

floo

d ar

ea,

cons

ider

wha

t m

itiga

tion

mea

sure

yo

u ca

n do

in

ad

vanc

e.

For

exam

ple,

in

high

ly fl

ood-

pron

e ar

eas,

kee

p m

ater

ials

on

ha

nd

like

sand

bags

, pl

ywoo

d,

plas

tic s

heet

ing,

pla

stic

gar

bage

bag

s, l

umbe

r, sh

ovel

s, w

ork

boot

s an

d gl

oves

.

A tr

opic

al

cycl

one

is

a st

orm

sy

stem

ch

arac

teriz

ed

by

a la

rge

low

-pre

ssur

e ce

nter

an

d nu

mer

ous

thun

ders

torm

s th

at

prod

uce

stro

ng w

inds

and

hea

vy r

ain.

Tro

pica

l cy

clon

es

stre

ngth

en

whe

n w

ater

ev

apor

ated

fro

m

the

ocea

n is

rel

ease

d as

the

sat

urat

ed a

ir ris

es,

resu

lting

in

co

nden

satio

n of

w

ater

va

por

cont

aine

d in

the

moi

st a

ir. T

hey

are

fuel

ed b

y a

diffe

rent

hea

t m

echa

nism

tha

n ot

her

cycl

onic

w

inds

torm

s su

ch

as

nor’e

aste

rs,

Euro

pean

w

inds

torm

s, a

nd p

olar

low

s. T

he c

hara

cter

istic

th

at

sepa

rate

s tr

opic

al

cycl

ones

fro

m

othe

r cy

clon

ic

syst

ems

is

that

an

y he

ight

in

th

e at

mos

pher

e, the

cen

ter

of a

tro

pica

l cyc

lone

will

be

war

mer

tha

n its

sur

roun

ds;

a ph

enom

enon

ca

lled

“war

m c

ore”

sto

rm s

yste

ms.

In

the

past

tw

o ce

ntur

ies,

tro

pica

l cyc

lone

s ha

ve c

ause

d an

es

timat

ed 1

.9 m

illio

n de

aths

wor

dlw

ide.

Wha

t to

do w

hen

a

cyclone

watc

h is is

sued

Re-c

heck

you

r pr

oper

ty fo

r an

y lo

ose

mat

eria

l an

d tie

do

wn

(or

fill

with

w

ater

) al

l la

rge,

re

lativ

ely

light

item

s su

ch a

s bo

ats

and

rubb

ish

bins

.Fi

ll ve

hicl

es’ f

uel t

anks

. Ch

eck

your

em

erge

ncy

kit

and

fill

wat

er

cont

aine

rs.

Ensu

re h

ouse

hold

mem

bers

kno

w w

hich

is

the

stro

nges

t par

t of t

he h

ouse

and

wha

t to

do in

th

e ev

ent o

f a c

yclo

ne w

arni

ng o

r an

evac

uatio

n.Tu

ne

to

your

lo

cal

radi

o/TV

fo

r fu

rthe

r in

form

atio

n an

d w

arni

ngs.

Chec

k th

at n

eigh

bors

are

aw

are

of th

e si

tuat

ion

and

are

prep

arin

g.

Wha

t to

do w

hen

a

cyclone

warn

ing is

issu

edDe

pend

ing

on o

ffici

al a

dvic

e pr

ovid

ed b

y yo

ur

loca

l aut

horit

ies

as th

e ev

ent e

volv

es; t

he

follo

win

g ac

tions

may

be

war

rant

ed.

If re

ques

ted

by

loca

l au

thor

ities

, co

llect

ch

ildre

n fro

m s

choo

l or

child

care

cen

ter

and

go

hom

e.Pa

rk v

ehic

les

unde

r sol

id s

helte

r (ha

nd b

rake

on

and

in g

ear)

.Pu

t w

oode

n or

pla

stic

out

door

fur

nitu

re i

n yo

ur p

ool o

r in

side

with

oth

er lo

ose

item

s.Cl

ose

shut

ters

or bo

ard-

up o

r he

avily

tape

all

win

dow

s.

Draw

cur

tain

s an

d lo

ck d

oors

.Pa

ck a

n ev

acua

tion

kit o

f war

m cl

othe

s, e

ssen

tial

med

icat

ions

, ba

by f

orm

ula,

nap

pies

, v

alua

bles

, im

porta

nt

pape

rs,

phot

os

and

mem

ento

s in

w

ater

proo

f bag

s to

be

take

n w

ith y

our e

mer

genc

y ki

t. Larg

e/he

avy

valu

able

s co

uld

be p

rote

cted

in

a st

rong

cup

boar

d.Re

mai

n in

door

s (w

ith y

our

pets

). St

ay t

uned

to

you

r lo

cal r

adio

/TV

for fu

rthe

r in

form

atio

n.

Brochure

Appen

dix

74

Creative cont’dWebsite

Append

ix

75

Creative cont’d

T-‐shirts

Promotional Items

FRONT

BACK

Fly swatters

Appen

dix

76

Creative cont’d

Reusable water bottles

Promotional Items

Append

ix

77

Creative cont’d

Sweatbands Baseball caps

BandanasTote bags

Promotional Items